A comparison of methods for determining the ventilatory threshold: implications for surgical risk stratificationAbstractPurposeThe ventilatory threshold (VT) is an objective physiological marker of the capacity of aerobic endurance that has good prognostic applications in preoperative settings. Nevertheless, determining the VT can be challenging due to physiological and methodological issues, especially in evaluating surgical risk. The purpose of the current study was to compare different methods of determining VT and to highlight the implications for assessing perioperative risk.MethodsOur study entailed analysis of 445 treadmill cardiopulmonary exercise tests from 140 presurgical candidates with an aortic abdominal aneurysm ( ≥...Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Perioperative implications of thoracic decortications: a retrospective cohort studyConclusionThere has been a ninefold increase in decortications over an eight-year period. Potential causes include an increase in the incidence of pneumonia, increased organism virulence, host changes, and changes in practice patterns. Patients undergoing decortication for infectious causes had an increased risk for adverse perioperative outcomes. Anesthesiologists need to be aware of the high perioperative morbidity of these patients and the potential need for postoperative admission to an intensive care unit. (Source: Canadian Journal of Anesthesia)Source: Canadian Journal of Anesthesia - May 10, 2017 Category: Anesthesiology Source Type: research

Airway management outside the operating room: how to better prepareThis article provides a practical review of how that evidence applies during emergency airway management outside of the operating room. To counter the challenges of airway management outside the operating room, we offer a mnemonic that combines both technical and non-technical insights summarized using the seven letters of the word PREPARE (P: pre-oxygenate/position; R: reset/resist; E: examine/explicit; P: plan A/B; A: adjust/attention; R: remain/review; E: exit/explore). We hope it can unite potentially disparate personnel with a structure that allows them to make acute decisions, coordinate action, and communicate unequ...Source: Canadian Journal of Anesthesia - April 1, 2017 Category: Anesthesiology Source Type: research